Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

The final version of a spending bill released late Monday would unravel school lunch standards the Agriculture Department proposed earlier this year, which included limiting the use of potatoes on the lunch line and delaying limits on sodium and delaying a requirement to boost whole grains.

The bill also would allow tomato paste on pizzas to be counted as a vegetable, as it is now. USDA had wanted to prevent that.

Food companies that produce frozen pizzas for schools, the salt industry and potato growers requested the changes, and some conservatives in Congress say the federal government shouldn't be telling children what to eat.

Republicans on the House Appropriations Committee said the changes would "prevent overly burdensome and costly regulations and to provide greater flexibility for local school districts to improve the nutritional quality of meals."

School districts had said some of the USDA requirements went too far and cost too much when budgets are extremely tight. Schools have long taken broad instructions from the government on what they can serve in federally subsidized meals that are served free or at reduced price to low-income children. But some schools have balked at government attempts to tell them exactly what foods they can't serve.

Reacting to that criticism, House Republicans had urged USDA to completely rewrite the standards in their version of the bill passed in June. The Senate last month voted to block the potato limits in their version. Neither version included the language on tomato paste, sodium or whole grains, which was added by House-Senate negotiators on the bill.

The school lunch proposal was based on 2009 recommendations by the Institute of Medicine, the health arm of the National Academy of Sciences. Agriculture Secretary Tom Vilsack said they were needed to reduce childhood obesity and future health care costs.

Nutrition advocate Margo Wootan of the Center for Science in the Public Interest said Congress's proposed changes will keep schools from serving a wider array of vegetables. Children already get enough pizza and potatoes, she says. It would also slow efforts to make pizzas — a longtime standby on school lunch lines — healthier, with whole grain crusts and lower levels of sodium.

"They are making sure that two of the biggest problems in the school lunch program, pizza and french fries, are untouched," she said.

A group of retired generals advocating for healthier school lunches also criticized the spending bill. The group, called Mission: Readiness has called poor nutrition in school lunches a national security issue because obesity is the leading medical disqualifier for military service.

"We are outraged that Congress is seriously considering language that would effectively categorize pizza as a vegetable in the school lunch program," Amy Dawson Taggart, the director of the group, said in a letter to members of Congress before the final plan was released. "It doesn't take an advanced degree in nutrition to call this a national disgrace."

Specifically, the provisions would:

Block the Agriculture Department from limiting starchy vegetables, including corn and peas, to two servings a week. The rule was intended to cut down on french fries, which some schools serve daily.

Allow USDA to count two tablespoons of tomato paste as a vegetable, as it does now. The department had attempted to require that only a half-cup of tomato paste could be considered a vegetable — too much to put on a pizza. Federally subsidized lunches must have a certain number of vegetables to be served.

Require further study on long-term sodium reduction requirements set forth by the USDA guidelines.

Require USDA to define "whole grains" before they regulate them. The rules would require schools to use more whole grains.

Food companies who have fought the USDA standards say they were too strict and neglected the nutrients that potatoes, other starchy vegetables and tomato paste do offer.

"This agreement ensures that nutrient-rich vegetables such as potatoes, corn and peas will remain part of a balanced, healthy diet in federally funded school meals and recognizes the significant amounts of potassium, fiber and vitamins A and C provided by tomato paste, ensuring that students may continue to enjoy healthy meals such as pizza and pasta," said Kraig Naasz, president of the American Frozen Food Institute.

The school lunch provisions are part of a final House-Senate compromise on a $182 billion measure would fund the day-to-day operations of the departments of Agriculture, Commerce, Justice, Transportation and Housing and Urban Development. Both the House and the Senate are expected to vote on the bill this week and send it to President Barack Obama.

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